Dear Fizzy, MD:

Your article on part-time physicians “ruining” medicine really struck a chord with me.  That you, as a mother and a wife, chose to prioritize your wholeness and family above career is commendable. I applaud your courage to chart your own course in the face of a work culture that undermines your wellbeing while at the same time, expects you to deliver health and healing to others selflessly. Your story also resonated strongly with my Facebook friends — many of whom are just starting their medical careers and confronting the realities of our health care system.

Physicians should work part time and/or cut back on extracurricular engagements. As we have all read, burnout can lead to depression and possibly even suicide.  In fact, it has been noted that about 400 physicians commit suicide each year. That’s roughly the size of 1 to 2 medical school classes dying prematurely each year. Female physicians are most at risk at 2.3 times the suicide rate of the average female working population.

Why has this become acceptable in our profession? Why are we not organizing in large numbers to fight for our own mental and emotional health? Have we become so complacent as a group that we are willing to let our colleagues and ourselves risk death for the sake of obedience and “not rocking the boat”?

Obviously the answers to these questions are complex, however, as a formerly burnt-out full-time physician, I am no longer willing to sit back silently and watch colleagues and friends struggle with burnout and depression. I have joined forces with a fellow female physician, Meeta Shah, MD, and together we have created Female Physicians United For Change (FPUFC) — a closed Facebook group with over 1,400 physician members. FPUFC’s mission is to identify and resolve issues in the practice of medicine as they relate to female physicians and “advocate for the rights of our patients, ourselves and our families.”

In a matter of weeks, since the creation of this group, members of FPUFC have identified multiple issues uniquely faced by female physicians ranging from unequal pay for equal qualifications to receiving fully paid maternity/family leave pre- and post-partum.

Some residents are forced back to work after only 1 to 2 weeks post-partum due to not having back-up amongst co-residents. It is no wonder so many female physicians have felt their only option is to work part-time to have a chance at obtaining some semblance of work-life balance. These problems are grievously unacceptable, especially given the scientific knowledge we espouse to patients about the importance of maternal-newborn bonding and breastfeeding. I don’t believe there is any excuse for this hypocrisy, and I believe it is time for sweeping change towards a more humanized practice of medicine, for physicians and patients.

As your example highlights, Fizzy, a greater acceptance of part-time physicians can solve many of these issues.

One disturbing issue you raised in your article about working part-time, is the guilt you have regarding your colleagues working full time and having been given a hard time about it.

To use guilt and shame as perverse motivators in the health care profession is astonishing and it must stop. To shame someone for working fewer hours and taking care of their individual needs is abhorrent, especially given the alternative of burnout, depression, and possible suicide. If we are to attract and retain physicians who are passionate about welfare and health, cultural change must happen quickly, and it must start from within.  After all, there is no better source of energy and productivity than a fulfilled and nurtured human being.

We must explore our individual differences and needs and attend to them in order to fix the system. To do this, we need all hands on deck. We must put aside differences between specialties and unite to create a more nurturing, compassionate and caring culture within our profession.

Believe it or not, we’re all in this together: full, part or overtime. We all choose our path in terms of what works (or doesn’t) for ourselves and our families.

The future of medicine lies in our hands. The question is, will we choose a future of continued physician misery and burnout or will we collectively take steps to advocate for and support each other in self-care?

In full support of self-care,

Ashley Maltz

Ashley Maltz is an integrative medicine physician and can be reached on her self-titled site, Ashley Maltz, MD, MPH.

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